The effects of anxiety on arousal in sexually dysfunctional women

The effects of anxiety arousal on subsequent sexual arousal were investigated to determine if sexually functional and dysfunctional women respond differentially to pairings of anxiety-evoking and erotic cues. Eight sexually dysfunctional and eight sexually functional women viewed a neutral control (travelogue videotape) or anxiety-evoking (threatened amputation videotape) preexposure stimulus followed by a sexually arousing (erotic videotape) experimental stimulus. A repeated measures design was used in which each subject observed both pairs of preexposure and experimental stimuli. Changes in sexual arousal were measured physiologically with a vaginal photoplethysmograph, and subjectively with a self-report rating scale. As predicted, functional women showed significantly greater physiological sexual arousal than dysfunctional women in both the neutral-erotic and anxiety-erotic conditions. Consistent with previous research, anxiety preexposure significantly enhanced genital arousal relative to the neutral-control stimulus for functional women. Moreover, dysfunctional women also achieved a significantly enhanced rate and magnitude of genital arousal following exposure to the anxiety stimulus. Contrary to the strength of their physiological responses however, both groups rated the anxiety-erotic condition as significantly less sexually arousing. Non-significant correlations between vaginal blood volume and subjective ratings revealed a trend for functional and dysfunctional women to experience enhanced genital arousal accompanied by an inhibited likelihood of acknowledging feeling aroused. These findings contradict the literature on sexually functional and dysfunctional men, and challenge current conceptualizations of sexual dysfunction. The findings suggest that (1) anxiety arousal enhances genital arousal in functional and dysfunctional women, (2) heightened arousal occurs despite contradictory cognitive perceptions, (3) the female sexual response system is desynchronous, (4) functional women do not necessarily process genital cues more effectively than dysfunctional women, (5) the physiological response system is imperative to defining a response as sexual and must be targeted in therapy, and (6) common modes of treatment directed toward increasing parasympathetic response may be counterproductive to the elicitation of sexual arousal. Alternative treatment strategies directed toward response synchrony, sympathetic activation, and cognitive attribution are discussed. A preliminary model of sexual dysfunction in women is proposed, .and discussed in terms of directions for future research.Arts, Faculty ofPsychology, Department ofGraduat